Category: Disease

Introduction

Multiple Myeloma is the phenomenon, which requires continuous attention, as it changes over particular time. Doctors were trying to find the possible cure for the disease since 1960s¹. Additionally, it could be said that this blood disease is widespread, as it is the second most frequent blood malignancy in the United States of America¹.

A primary goal of this research paper is to discover the causes, prevalence, pathophysiology, and a relation of the laboratory data to the determination of the disease of multiple myeloma. It is essential to analyze each aspect precisely to establish potential treatment for the disease. In the end, summary and conclusions are drawn.

Cause of Multiple Myeloma

It was hard to identify the original reason for the existence and development of multiple myeloma, as the disease was rather complex, and the origin was hard to determine. However, it became apparent that B cells are the primary sources of the illness and distribution of the tumor since these cells have the ability to divide rapidly². Now it is clear that it is necessary to stop the production and distribution of the disease with the assistance of elimination of B cells, which spread the disease to the healthy blood cells.

Prevalence

As for the prevalence, it is the second blood malfunction disease in the United States of America¹. Moreover, the average age for the disease diagnosis is around 61-62 years old for men and women¹. The case of this illness occurs rather often in the United States of America. However, it is apparent that multiple myeloma has a tendency to exist in the other countries. Another interesting fact, which was revealed, is that the disease has a tendency to occur more with men than in women¹. Nonetheless, the dependency on the sex, race, and location has not been revealed, as the disease coverage remains high in the world.

Pathophysiology

As for the pathophysiology, multiple myeloma is characterized by the excessive number of the bone marrow cells, bone fracturing, renal malfunction, and lack of sufficient functioning of the immune system¹. However, it has to be mention that multiple myeloma has a tendency to progress and change its appearance in the different stages of development. One of the examples of the multiple myeloma final progression is the plasma cell leukemia, as the function of bone marrow cell production is significantly disturbed.

Relation of laboratory data to diagnosis of disease

As for the relevance of the laboratory testing, it is apparent that myeloma protein is diagnosed in the patients serum⁴. It is apparent that the presence of the myeloma protein helps determine the existence of multiple myeloma in the cells of the patient. The protein can be located in urine or serum of the patient¹. Moreover, hyperkalemia also takes place, as it is connected to the serum escalation³. Additionally, the laboratory testing has to show the increased level of creatnine¹. It is apparent that changes in the patient laboratory data contribute to the existence of the multiple myeloma if the analysis has all the required characteristics mentioned above.

Summary and Conclusion

It is apparent that the spread of the disease will continue to evolve. The prognosis of the illness depends on the stage of the diagnosis³. It is apparent that the patients, who were diagnosed in the first phase, have more chances to survive and live in prosperity than patients with the later diagnosis.

As for the treatment, one of the possible treatments is ASCT, as alkylators might have an adverse effect on the stem formation³. In this case, several cycles of induction therapy are required. Nevertheless, if the ASCT treatment is not possible, oral regimen MP is used to avoid high levels of the intoxication³. Nonetheless, the chosen treatment depends on whether the patient has complications. In this instance, such medicine as glucocorticoids, alkylators, and thalidomide can be used.

References

1. Raab MS, Podar K, Breitkreutz I, Richardson P, Anderson KC. Multiple myeloma: The Lancet. 2009; 374(9686):324-339.
2. Khabir A. Unique B cells cause multiple myeloma: Lancet Onc. 2004; 5(1):3.
3. Rajkumar SV, Kyle RA. Multiple myeloma: diagnosis and treatment. Mayo Clin Proc. 2005; 80(10):1371-82.
4. Murphy K. Immunobiology. 8th ed. New York: Garland Science, Taylor & Francis Group, LLC; 2012.

Introduction

Epidemiology is a scientific subject that assesses the elements and distribution of illness and injury in people groups through space and time. Epidemiologic methods refer to the various concepts applicable in finding the causes of diseases and other healthcare concerns in a community (Huremovi, 2019). The epidemiologic models and systems serve a vast selection of purposes in disease examinations and healthcare research, including measuring the mortality and morbidity of a specific population, identifying the cause of a given health disorder, and examining the performance of analytic, healing, and precautionary measures (Huremovi, 2019). Therefore, the prevention of infectious diseases is necessary to minimize the spread and consequences of such illnesses. This research focuses on epidemiologic concepts, theoretical frameworks, and study designs in the context of infectious diseases. It further aims to assess the epidemiology of contagious illnesses and recommend reducing virus spread and transmission.

Statement of the Problem

Infectious diseases are the primary cause of increased mortality and morbidity experienced in the current society. Their transmission is linked to human civilization, including animal domestication and urbanization. These factors led to the spread of viral infections and airborne bacteria, which are presently detrimental to human existence. Therefore, this research problem is significant since it clarifies the social context of the severity of infectious diseases, apart from assessing the probable methods of controlling viral spread and transmission.

Definitions of Disease Occurrence

Epidemiologists categorize illness cases and incidence of illness in a community as either epidemic and endemic. An Endemic is the regular event of infection in a group of people, whereas an epidemic is an unexpected and significant increase in a populations condition. It can give a boost to an epidemic, a fast-developing occurrence of illness that upsets persons within a vast topographical zone (Huremovi, 2019). For instance, when a small group of individuals is infected by influenza within a year in a big city, they are regarded as prevalent cases of the illness. Conversely, when the number of individuals influenced by the disease within a similar town escalates to significant winter stages, the occurrence has measured as an epidemic. Finally, if a new variation of the condition arises and distresses individuals globally, the occurrence is regarded as a pandemic.

Basic Tools of Epidemiology

A vast array of public healthcare concepts is available to help in illness investigation and wellness research. The key strategies include mapping, web-based reporting, and laboratory techniques. The methods help medical experts identify causes of health conditions, examine the mortality and morbidity of a specific population, understand the history and course of the disease, and assess the influences of analysis, therapy, and preventive frameworks of a public health course (Huremovi, 2019). Epidemiologic concepts and tools offer empirical evidence to establish community health policies to enhance human wellness. Epidemiology is founded on two fundamental assumptions. First, illness is not regular, which means that several aspects impact developing the disease. Second, the research on inhabitants allows for identifying the causes and preventive measures like conditions (Huremovi, 2019). Consequently, to explore sickness in people, epidemiologists depend on definitions and models of disease incidence and employ different apparatuses.

Mapping

The creation of a progressively refined geographical data structure (GIS) has delivered an innovative set of implements for community healthcare experts to observe and react to fitness concerns. These systems benefit in identifying contacts and cases, recognizing spatial tendencies, detecting disease groups, comparing a distinct set of spatial information, and examining numerical hypotheses (Rumpf et al., 2019). Regularly these studies are helped by the conception and plotting of data, delivered via web facilities or consumer interfaces. The GIS systems are used in geocoding, incorporating statistics causes, and cluster acknowledgment. Plotting of statistics is attained via dot graphs, choropleth registers, and gradient plots (Rumpf et al., 2019). Regular reflections cited in these encompass the seclusion of public health information, the arrangement of GIS analytics to consumers needs, incentives to make examination amenities available, and the systems interoperability.

Laboratory Experiment

Laboratory testing is established by accepting the dissemination and grouping of genomic variations, strains, pigeonholes, and other pathogens molecular clusterings. In molecular epidemiology, the connection amongst segregates is frequently designed and communicated through phylogenetic diagrams. Conception tools for laboratory research often comprise phylogenetic examination and picturing abilities and background statistics using linked charts (Rumpf et al., 2019). The tools for this type of epidemiological assessment are planned to be retrieved over the internet. Numerous studies have involved the proficiency to incorporate GIS or location-built information with genetic conceptions. Consequently, two of the implements are plans to generate image (KML) records for presentation in new GIS sets. In contrast, other internet tools exploited exterior GIS facilities connected to the website, mainly google charts and health charts, to develop policies.

Web-based Recordings

In addition to laboratory experiment and mapping data, web recordings is increasingly used to understand disease outbreaks through social network assessment. Regarding describing the practice of social-network conceptions for community health, healthcare professionals have reflected on the vast set of periodicals that regularly describe visualization of particular occurrences and evaluates (Rumpf et al., 2019). Presentations of social-network assessments in community health generally center on contagion methods in infectious illness contact studies; thus, most research papers have defined the topic. The objective of web-based recordings comprises risk fulfillment of connections, recognizing collective appearances of the infected, visually plotting and interconnecting cases for enhanced understanding of occurrences, and distinguishing possible ways of spread.

Epidemiological Articles Interpretations

Epidemiologists usually utilize various articles to illustrate the existence of a disease. The frequently used concept views illness in terms of vulnerability and contact factors. It assumes that people should be both vulnerable and exposed to an individuals condition to develop sickness (Tang et al., 2017). For instance, for a person to contract measles, an infectious disease common amongst infants, the patient should have been subjected to a host who is shedding the measles disease and lacks resistance to the illness. Resistance to measles may be resultant from either formerly having had the ailment or being immunized counter to it.

An alternative frequently used system is the epidemiological triad, which perceives illness as the balance of environment, host, and agent factors. The epidemiological triad is a conceptual theory employed by epidemiologists to interpret the causes of illness since it has evolved from the research of contagious diseases and other healthcare concerns (Tang et al., 2017). The models central assumption is that infections are instigated by the interaction of three constituent factors, such as environment, agent, and host. The agent is the potential or actual casualty of the sickness. Hosts inhibit features that either protect or incline them to the disease (Tang et al., 2017). The parts are usually biological, such as age, degree of resistance, sex, behavior, lifestyle, traditions, ethos, social; norms, values, and attitudes.

Conversely, the agent aspect refers to the causes of illness, including chemical, nutritional, physical, and biological factors. The environment contains all the exterior dynamics apart from the host and causes that impact healthcare. The surroundings can either be societal, physical, and biological (Tang et al., 2017). Furthermore, to explain the epidemiological triad concept, the situation of lung cancer can be employed. The carrier is the individual who has developed a lung tumor. The patient may have been an active smoker for a significant period. Therefore, the agents are tar, harmful chemical, and the smoke enclosed in the tobacco. The surroundings, in this case, are the work setting where smoking on the job was allowed, and smoking locations were readily available.

Study Designs in Epidemiology

In epidemiology, scientists are fascinated by assessing the connection of contact with disease or consequences. First, they describe the theory centered on the study request and then conclude which research design will be appropriate to respond to the problem. A particular study scheme establishes the methods for conducting the examination. Experimental and observational research designs are substantial in studying contagious infection epidemiology (Giesecke, 2017). Numerous researchers utilize relatively small samples, increasing random errors in infectious illness studies. They are using inappropriate assessment tools and failing to include proactive recruitment increasing systematic errors, aside from compromising standardized diagnostic processes.

Experimental Studies

Randomized control trials (RCT) are regarded as the principal average of a study plan. In RCT, the scholar casually allocates the issues to a regulator faction and investigational group. Indiscrimination prevents confusion and reduces assortment preference, thus enabling researchers to have comparable investigational and control units (Giesecke, 2017). The testing team gets the treatment to be an agent convoluted in the care, avoidance, and causation of a disease. The sample group gets no cure, a palliative cure, or alternative ordinary precaution treatment reliant on the researchs goal. Furthermore, the groups are then monitored regularly to distinguish who improves the consequence of interest. However, the RCT design is costly, and scholars who employ it face challenges with the reliability of randomization owed to rejections, non-compliance, dropouts, and crossovers.

Observational Studies

The observational studies are divided into distinct groups, such as case-control and case-crossover studies. First, case-control research is employed to determine the relationship between various threats and results. The factors that affect the risk of disease are referred to as exposures. Case-control studies can aid in identifying beneficial and harmful vulnerabilities. There are two categories of patient cases and controls in the study, where the cases are persons who have a specific disease, disability, and condition. In contrast, controls are the individuals who do not inhibit the disease symptoms (Giesecke, 2017). Typically, researchers recognize suitable demonstrative controls for the circumstances that they are investigating from the general public. Afterward, they retrospectively examine the historical medical records for the patients earlier exposures, which may have exposed them to a specific risk issue.

Choosing the persons for the regulation collection is a vital aspect of a study built on situation-control research. Due to the reflective description of the study design, case-control surveys are matters to recall prejudice (Giesecke, 2017). However, case-control reviews are economical, resourceful, and less time-consuming, thus suitable for analyzing uncommon illnesses that have prolonged dormancy periods. The second type of observational study type is case-crossover, which helps study triggers within a person (Giesecke, 2017). It is also beneficial when the researcher is investigating a quick contact or threat factor. The study design assumes that case and control components originate from the same person. Therefore, every situation is self-matched by helping as its regulator. Therefore, defining the case and resistor mechanisms period is a vital and challenging characteristic of case-border research.

Screening and Assessment of Infectious Disease

Disease Screening and Selection

The process involves two independent medical professionals screening the samples of a specific disease and comparing the current results to the study population. During the screening, all information is analyzed on the target group to determine any genomic and biological sequence of the disease and how it integrates with the human body (Epstein et al., 2018). The determined results were retrieved as whole samples for the second screening by two independent medical research laboratories. Such a move is to ensure conclusive statistics are made before the implementation of preventive measures. The discrepancies between the two resulting data are resolved through consultation and discussion with a third party if a traditional approach is not established between the two initial scientists.

Information Assessment

Information extracted from the studies is recorded, including the biological information of the pathogens virus and its impacts on the patients. The researchers usually use various prevailing frameworks to guide data extraction since they present a template to direct information extraction and aid to standardize the collection of statistics across included researchers and scientists (Epstein et al., 2018). The move will help realize the general objective of finding evidence to respond to research questions while also offering a transparent and reproducible methodology. The frameworks are usually employed to collect supplementary data from each isolated individual while including descriptions of the intervention and comparator treatment models. Finally, progress frameworks are used to consider social determinants of healthcare, such as age, sex, culture, socio-economic status, and environment.

Recommendations

A significant encounter for upcoming designers of data conception tools for community health is planning and developing the implements in expansive settings of present information, prevailing procedures and facilities, group partnerships, and inter-corporation and inter-faculty requirements. The current systems are entry-controlled, thus regulating their utilization in contagious illness epidemiology, and might have accomplished their visualization features (Killin, 2020). Therefore, visualization tools of the prospect created by researchers to be harmonious with prevailing information arrangements and principles and interoperable. The tools should further adjust to the swelling compression to be open-access, permitting consumers from low-reserve locations, academic circles, and businesses to maximize visualization and surveillance technology innovations.

Alteration of the illness examination arena to enhance security and healthcare will need scholars to continue strengthening the methodical basis of infectious diseases epidemiology by implementing progress in bioinformatics, data, and other fields. The medical researchers can then incorporate their effort into bio-mechanical production, pain treatment, rehabilitation, and emergency medical services. New technological inventions will profoundly influence future studies and the practice of infectious illness epidemiology (Killin, 2020). The researcher should employ appropriate analysis and actual samples to prevent random faults. Satisfactory valuation of the co-founding variables is vital to evade systematic unfairness in the study of infectious illnesses. Furthermore, sanitization of persons and decontamination of surroundings contagious is necessary for infectious illness control (Killin, 2020). It is essential to seclude patients exposed to contagious diseases distant from vector hygiene and control surveillance.

Conclusion

An illness is regarded as contagious if pathogens have reproduced inside the host and become infectious upon contact with the new bacterium in the host. This research has discovered that transmissible diseases are the principal source of mortality and illness in human existence. Experimental and observational study plans are relevant and established to be significant in the reading of conditions. The prominent models of epidemiologic tools in the study comprise mapping, laboratory testing, and web-based recording. They help detect diseases and evolve associated public healthcare guidelines. The literature reviewed discovered that non-proactive enrollment, unreliable tools, and inadequate samples impact epidemiologic approaches. Additionally, epidemiological methods have played a significant part in disease studies, especially in identifying and describing harms as a community health concern, recognizing and accepting the various unintentional aspects of illness, and evolving and examining involvement initiatives to moderate the threat. Similarly, healthcare professionals have contributed substantially to the development of contemporary epidemiological methodology and concepts.

References

Epstein, D. J., Dunn, J., & Deresinski, S. (2018). Infectious complications of multiple sclerosis therapies: Implications for screening, prophylaxis, and management. Open Forum Infectious Diseases, 5(8), 169-174.

Giesecke, J. (2017). Modern infectious disease epidemiology. CRC Press.

Huremovi, D. (2019). A brief history of pandemics (pandemics throughout history). In Psychiatry of pandemics, 735. Springer.

Killin, L. (2020). The impact of a health technology improvement program on medication errors in three large, teaching hospitals in London Ontario, 38(12), 30-55.

Rumpf, H.-J., Brandt, D., Demetrovics, Z., Billieux, J., Carragher, N., Brand, M., Bowden-Jones, H., Rahimi-Movaghar, A., Assanangkornchai, S., & Glavak-Tkalic, R. (2019). Epidemiological challenges in the study of behavioral addictions: A call for high standard methodologies. Current Addiction Reports, 6(15), 331337. Web.

Tang, P., Croxen, M. A., Hasan, M. R., Hsiao, W. W., & Hoang, L. M. (2017). Infection control in the new age of genomic epidemiology. American Journal of Infection Control, 45(2), 170179.

Vincent Brody

 67 years old. Has a 50-year history of smoking 2 packs a day. Admitted with exacerbation of chronic obstructive pulmonary disease (COPD).

Related to stress and pain experienced as a result of COPD exacerbation

Priority Nsg Diagnosis # 1

Risk for respiratory distress symptoms:

• Subjective data: This cough is killing
• Objective data: No improvements in oxygen saturation levels;
• Resp: 23;
• SpO2: 94%;
• Elevated HCO3 and PCO2.

Current information

• Medical diagnosis: respiratory alkelosis
• Risk factors: COPD, old age, smoking, prior history of respiratory conditions
• Diagnostic tests: Chest X-ray, lung pulmonary function test, ABGs, CT scan
• Treatments: administration of opioid pain relieve medicine, providing a sufficient amount of oxygen to stop hyperventilation
• Medications: oxycodone, codeine, or morphine

Nsg interventions

Nursing interventions:

1. Increase inspired carbon dioxide (rebreathing)
2. Relieve pain and limit the sources of anxiety

Short-term goal: stop hyperventilation:

Long-term goal: limit the impact of the underlying condition (COPD) on alkelosis

Contributed to heightened anxiety and hyperventilation

Priority Nsg Diagnosis # 2

Emotional Distress:

• Subjective data: audible chest wheezes, shortness of breath
• Objective data: Difficulty breathing;
• Chest pain;
• HR-21;
• BP: 198/80

Current information

• Medical diagnosis: sinus tachycardia
• Risk factors: COPD, old age, excessive nicotine consumption, prior history of respiratory conditions
• Diagnostic tests: ECG, thyroid function tests
• Treatments: administration of the necessary medicine
• Medications: calcium channel blockers, ivabradine

Nsg interventions

Nursing interventions:

1. Administering anti-arrhythmic medication
2. Preventing cardiac emergencies

Short-term goal: slow the heart rate, stabilize the patient

Long-term goal: ensure there is no need for invasive therapy such as catheter ablation

In 2016, the Zika virus caused a widespread epidemic in several countries. The United States also suffered from this disease, as can be seen from the statistics published on the CDC website (2016 case counts, n.d.). To see a clear picture of the effects of Zika on the U.S. population, it is necessary to measure three components of epidemiology. They include the prevalence of the disease, cumulative incidence, and incidence rate (Gerber, 2018). The first parameter, prevalence, is directly connected to other indicators. It is defined as the proportion of people with disease at a given point in time (Gerber, 2018, p. 41).

Its formula is the number of diseased individuals divided by the total number of individuals (Gerber, 2018). In Florida, the population in 2016 was 20.61 million people (Resident population, n.d.). The number of infected citizens reached 1107, and the calculations allow for concluding on Zika prevalence of 5.4 % (2016 case counts, n.d.). This indicator and the calculations will be helpful in further analysis.

The second parameter is the cumulative incidence, which is also a proportion. This indicator reflects the disease frequency during a selected period (Gerber, 2018). It is calculated as the number of new cases between two points in time divided by the total number of individuals at risk at the beginning of the period (Gerber, 2018).

Hence, the cumulative incidence of Zika for 2016 is 5.3 %, according to the CDC (2016 case counts, n.d.). The third parameter is the incidence rate, which measures the rapidity of new cases occurring and is calculated as the number of new cases over the period divided by total person-time at risk (Gerber, 2018). Hence, the incidence rate of Zika in Florida is 93 persons per month.

References

2016 case counts in the US. (n.d.). Centers for Disease Control and Prevention. Web.

Gerber, J.S. (2018). Epidemiological methods in infection control. In E. Lautenbach, P.N. Malani, K.F. Woeltje, J.H. Han, E.K. Shuman, & J. Marshall (Eds.), Practical healthcare and epidemiology (pp. 41-51). Cambridge University Press.

Resident population in Florida 1960-2019. (n.d.). Statista. Web.

Introduction of Disease

Pelvic inflammatory disease (PID) is a disease of pelvic organs in women. Specifically, it is defined as an infection of the upper genital tract occurring predominantly in sexually active young women (Curry et al., 2019, p. 357). PID can cause infectious processing spreading through different parts of the reproductive system, including fallopian tubes, ovaries, the endometrium, and the peritoneal space (Curry et al., 2019). The disease presents a significant risk for young sexually active women as it affects most reproductive organs and can result in discomfort for the patient and impact their fertility.

According to Kreisel et al. (2017), 4.4% of women aged 18-44 in the United States, or approximately 2.5 million women, reported PID diagnosis in 2013-2014. Self-reports indicate a 5.7% prevalence among women of reproductive age during 2006-2010 (Kreisel et al., 2017). Furthermore, PID and other sexually transmitted infections (STI) are more likely to be undiagnosed in black women due to limited access to healthcare (Kreisel et al., 2017). As PID can be asymptomatic, it can be argued that the prevalence of the infection is higher than reported, while some patients prefer not to disclose the information.

Etiology and Risk Factors

PID is generally associated with a wide variety of etiologies. Thus, chlamydia and gonorrhea infections, two of the most common STIs, can cause PID development (Reekie et al., 2017). It can also be caused by different bacteria, including Mycoplasma genitalium and Trichomonas vaginalis (Reekie et al., 2017). PID is common for women of reproductive age (18-44 years) who are sexually active. It has to be noted that women younger than 25 years are at an increased risk of contracting PID (Kreisel et al., 2017).

Other risk factors include unprotected sexual intercourse, engaging in intercourse with multiple partners or a person who has multiple partners, intercourse with a symptomatic individual, and early onset of sexual activity (Curry et al., 2019). Furthermore, patients with STI are more likely to develop the infection. Overall, it can be argued that the patients lifestyle can be a risk factor for PID.

Pathophysiological Processes

Pathophysiology of PID involves the spread of infection through the reproductive system of the patient. Initially, the infection spreads from the vagina to the cervix and then to the upper genital tract and such organs as the fallopian tubes, ovaries, and the endometrium (Tao et al., 2018). PID can reach the upper genital tract organs from the tissue surrounding the uterus through the lymphatic system (Curry et al., 2019). The typical immune response to PID is a substantially increased white blood cell level that leads to fever, aches, and pelvic pain (Curry et al., 2019). However, PID can also be asymptomatic, leading to the infection remaining undiagnosed and untreated.

Clinical Manifestations and Complications

Several symptoms and clinical manifestations can indicate that the patient has PID. Pelvic pain and pain in the lower abdominal area that worsens during sexual intercourse is the primary symptom of the infection (Curry et al., 2019). Other signs include uterine bleeding, abnormal vaginal discharge, increased urinary frequency, and dysuria (Curry et al., 2019). In addition, the patient may experience fever, body aches, and nausea. If untreated, PID can lead to infertility, increased risk of ectopic pregnancy, and chronic pelvic pain (Kreisel et al., 2017). Overall, the majority of the symptoms can be associated with other infections and reproductive tract disorders. Therefore, it is essential for women with any discomfort to undergo diagnostic tests to determine whether they have PID.

Diagnostics

A presumptive diagnosis of PID is recommended for sexually active young women. According to Curry et al. (2019), the presence of mucopurulent discharge and other manifestations of lower genital tract infections and STIs can serve as the basis for PID diagnosis. However, it is recommended to conduct saline microscopy and assess its white blood cell count to diagnose PID (Curry et al., 2019). Other diagnostic procedures include bimanual examination for cervical motion, uterine tenderness, adnexal masses, and tubo-ovarian abscess (Curry et al., 2019). Overall, the infection can be diagnosed through a series of clinical procedures, speculum examination, and the patients history.

References

Curry, A., Williams, T., & Penny, M. M. (2019). Pelvic inflammatory disease: Diagnosis, management, and prevention. American Family Physician, 100(6), 357364.

Kreisel, K., Torrone, E., Bernstein, K., Hong, J., & Gorwitz, R. (2017). Prevalence of pelvic inflammatory disease in sexually experienced women of reproductive age  United States, 2013-2014. MMWR. Morbidity and Mortality Weekly Report, 66(3), 8083. Web.

Reekie, J., Donovan, B., Guy, R., Hocking, J. S., Kaldor, J. M., Mak, D. B., Pearson, S., Preen, D., Stewart, L., Ward, J., Liu, B., Liu, B., Preen, D., Hocking, J., Donovan, B., Roberts, C., Ward, J., Mak, D., & Guy, R. (2017). Risk of pelvic inflammatory disease in relation to chlamydia and gonorrhea testing, repeat testing, and positivity: A population-based cohort study. Clinical Infectious Diseases, 66(3), 437443. Web.

Tao, X., Ge, S., Chen, L., Cai, L., Hwang, M., & Wang, C. (2018). Relationships between female infertility and female genital infections and pelvic inflammatory disease: A population-based nested controlled study. Clinics, 73, 17. Web.

Introduction

Universal healthcare is already adopted in several countries, and their economic system is adjusted to effectively provide free medical care. Switching to it from any other plan is a complicated procedure regarding all the diseases and injuries. Most of the general measures and results will apply to the current situation with lung problems in the U.S. This paper will examine the economic factors that are connected to Chronic Respiratory Diseases and the concept of universal healthcare.

Economic Principles and Indicators

Universal healthcare allows people to receive appropriate medical help when they need it and not use their financial resources. In this case, the government system covers prevention, treatment, rehabilitation, and palliative care, according to the World Health Organization (WHO, n.d.). Such an approach means that spending is included in the budget planning either through a tax system or sponsorship. For example, Canadas Medicare receives just over 70% through taxation and the rest through private investors (Martin et al., 2018). The citizens feel proud of the system and continue paying taxes for it. This and several decades of practice indicate the successful implementation of universal healthcare in Canada.

Many U.S. citizens at the present moment cannot afford the treatment of asthma and other CRDs by paying for it themselves. Studies show significant medical spending as a considerable burden, especially for those with low- and middle-income (Patel et al., 2018). The situation is getting more complicated during COVID-19 and the global crisis times. Over 40% of Americans are likely to support the Universal Medical Care initiative (Lagasse, 2020). Such a response indicates that the U.S. Health and Economics Departments should consider changing the current medical care plans as they play a crucial role in resolving the massive CRD problems, whether it is another virus or pollution issue.

Economic Impacts

Chronic Respiratory Diseases, while being the primary concern during the COVID-19 pandemic, require different types of spending when being treated. That includes direct and indirect medical costs, about 35% of the total spending covering the medications (Lakiang et al., 2018). The duration of the CRD hospitalization and recovery phases affect the total cost of treatment. The COVID-19 cases sometimes require several months of medical care, which can amount to unbearable sums of money for some U.S. citizens. When compared to Canadian, the American health system appears relatively inefficient and expensive (Martin et al., 2018). The resources invested in American affordable medical care plans are outweighed by the unexpected and unpredictable spending during the pandemic.

The Larger Context

CRDs are a significant medical issue for many people all over the world. Millions died because of Chronic Obstructive Pulmonary Disease and asthma, whether caused by COVID-19, genetics, environmental problems, or allergies (To et al., 2020). The lung problems require massive spending on research, medicine production, therapies, and personnel training. Living with CRDs limits career opportunities, housing choices, traveling, and entertainment activities. Giving the guarantees of maximal financial and medical support to the population could encourage better resource distribution and lead to significant overall life quality satisfaction and less stress. Universal medical care could be the trigger for such economic change.

Using Canada as an example of successfully implementing universal healthcare, researchers can see that decentralized yet available country-wide coverage can be sufficient. The citizens support the medical help being available based on the need, as opposed to the financial state of the patient (Martin et al., 2018). Among other countries with similar strategies are Barbados, Cuba, and Costa Rica. One crucial aspect that the U.S. could learn from them is the collective and conscious effort of nearly all citizens and governmental institutions to incorporate free medical care for everyone (Scott, 2020). Besides, any human society is dynamic, and plans have to change according to the present needs and circumstances. There are always financial sacrifices and cuts the regulating organs need to enforce other departments to encourage a free healthcare system. American institutions could analyze and partially adopt this strategy, although long-term financial planning is required for such drastic changes. CRD patients in the U.S. today experience anxiety largely because decades without pandemics targeting lungs created an illusion of safety for those with chronic problems. The country, the people, and the insurance were not ready for Covid-19.

Healthcare Organizations Impact

Healthcare organizations propose and implement the most effective disease prevention and treatment systems designed by their employees. The WHO (n.d.) aims at providing a universal healthcare system for all the people on the planet. Their focus is not only on professional help in treating illnesses but improving the quality of life of all humans. However, both the financial and governmental sides of this issue make such ambitious plans challenging to fulfill. Financing has to come from businesses and governments that are understandably reluctant about investing in the foreign citizens health at a time of crisis, like the global one now.

The U.S. has Medicare, Medicaid, and the Health Insurance Exchanges systems implemented at the moment. They may not be perfect, but they also aim at the citizens possibility to receive the medical assistance needed (Centers for Medicare, n.d.). Since drastically changing the system is not in their jurisdiction, the current healthcare and insurance providers in the U.S. educate and spread awareness about the current possibilities in the medical environment.

Conclusion

Chronic Respiratory Diseases are costly to both the patients and the healthcare organizations. They affect the economic activity and the well-being of the citizens and require careful planning on the governmental level to achieve the best possible outcome. Universal healthcare is an efficient solution for providing the needed assistance in treating lung problems; however, changing the system requires many financial and social resources.

References

Centers for Medicare and Medicaid Services. (n.d.). Were putting patients first. Web.

Lagasse, J. (2020). Coronavirus pandemic makes universal healthcare more popular in latest Morning Consult poll. Healthcare Finance. 

Lakiang, T., Nair, N. S., Ramaswamy, A., & Singhal, U. (2018). Economic impact of chronic obstructive pulmonary disease: A cross-sectional study at teaching hospital in South India. Journal of Family Medicine and Primary Care, 7(5), 10021006. Web.

Martin, D., Miller, A. P., Quesnel-Vallee, A., Caron, N. R., Vissangjee, B., & Marchildon, G. P. (2018). Canadas universal healthcare system: Achieving its potential. The Lancet, 391(10131), 17181735. 

Patel, M. R., Press, V. G., Gerald, L. B., Barnes, T., Blake, K., Brown, L. K., Costello, R. W., Crim, C., Forshag, M., Gershon, A. S., Goss, C. H., Han, M. K., Lee, T. A., Sweet, S. & Gerald, J. K. (2018). Improving the affordability of prescription medications for people with chronic respiratory disease. An official American Thoracic Society Policy statement. American Journal of Respiratory and Critical Care Medicine, 198(11), 13671374. 

Scott, D. (2020). 9 things Americans need to learn from the rest of the worlds health care systems. Vox. 

To, T., Viegi, G., Cruz, A., Taborda-Barata, L., Asher, I., Behera, D., Bennoor, K., Boulet, L.-P., Bousquet, J., Camargos, P., Conceicao, C., Gonzalez Diaz, S., El-Sony, A., Erhola, M., Gaga, M., Halpin, D., Harding, L., Maghlakelidze, T., Masjedi, M. R.,& Yorgancioglu, A. (2020). A global respiratory perspective on the COVID-19 pandemic: Commentary and action proposal. European Respiratory Journal, 56, 2001704.

World Health Organization. (n.d.). Universal health coverage. 

This academic work is a laboratory report summarizing the results of a practical simulation of the epidemiological dynamics of a simulated population. Thus, the reports central tasks are to summarize the data obtained, answer the questions posed, and analyze the results critically.

Results

This lab reports main results were obtained using the Lab Disease online simulation tool to quantitatively predict the incidence dynamics in the simulated population for a selected infectious disease. KOLD disease was investigated for samples of three sizes to determine the pattern of respiratory disease prevalence in patients as a function of regional population density. The simulation data are shown in the two parts of Table 1. It is noteworthy that each simulation run yielded unequal results because it is difficult to expect identity in the case of clinical trials. The spread of a contagious disease is individual and depends on many factors, including sample size and homogeneity, innate genetic resistance, and vaccination.

As can be seen, as the sample population increased in size, the incidence of the disease naturally increased. The number of infected people was calculated as the total number of sick days divided by the average duration of illness (equation [1]), and the infection rate as the proportion of infected people from the total number of vulnerable group (equation [2]). Thus, the CR infection rates dependence on the population size is practically linear, as shown in Figure 1. Consequently, for too low a density, the need for strict clinical restrictions is less than for high densities, where quarantine and universal vaccination are required. For low densities, these steps are selective vaccination, control, and tracking of individual cases.

Table 1: Disease Simulation

The second important result in this laboratory report was to find a relationship between the vaccinated population and the total number of infections and deaths. The working hypothesis was that a large number of vaccinated individuals in the sample leads to an expectedly low mortality outcome (Disease in Vaccinated Populations). Table 2 summarizes the simulation data for Impfluenza, the average duration of which was equated to three days according to the tool settings.

Table 2: Vaccine Simulation

As shown in Table 2, as the proportion of vaccinated people increased to 90%, a significant reduction in the infections and deaths cases in the simulated sample was observed. Thus, the average number of infections for the first scenario was 30 (equation [3]), whereas when the proportion increased to 90%, this parameter was numerically equal to three ([4]). In a comparative analysis, the vaccine for the medium density sample reduced the number of infections by 90% ([5]). It was also measured that when the 75% vaccinated mark was reached, the CR per capita did not exceed 0.1.

Conclusion

In conclusion, it should be noted that the study of epidemiological situations is a statistical task aimed at the numerical analysis of individual scenarios. The report showed that the higher the population density, the higher the infection rate among people due to residence proximity and the frequency of social contacts. It was also demonstrated that increasing the proportion of people who are vaccinated significantly reduces infection rates. This laboratory work is a useful material for studying the theory of epidemiology and predicting COVID-19 scenarios. Since this viral disease is highly contagious, reducing social contact, distancing, and universal vaccination should be an effective weapon to suppress the pandemic.

Works Cited

Disease in Vaccinated Populations. University of Oxford, 2020, Web.

Lab Disease. The Habitable Planet, n.d., 2021. Web.

Patients who suffer from congestive heart failure (CHF) have several recommendations regarding traveling and transportation. The increasing popularity of air flights demands to follow special requirements in utilizing passengers with cardiovascular diseases. As most commercial aircraft fly at an altitude between 22000 and 44000 feet above sea level, people with cardiovascular diseases are highly affected by decreased atmospheric pressure and humidity, gas expansion, extended immobility, and increased physical and emotional stress (Hammadah et al., 2017). Moreover, passengers with underlying heart failure could face increased hypoxia due to lower baseline oxygen levels at altitude. Hammadah et al. (2017) say that air flight conditions impact the blood circulation, including local vasodilatation of coronary and cerebral vascular beds, and vasoconstriction in the pulmonary vascular beds. Along with immobilization during air travel, people also experience fear and anxiety related to landing and security measures. All the factors mentioned above drastically influence patience with CHF and other heart diseases.

To avoid complications and exacerbations, patients with CHF should keep specific rules during air flights. In addition to that, air companies should prepare special medical equipment and provide instructions to staff. For example, Hammadah et al. (2017) state that general oxygen supplementation is needed on the plane, while Koh (2021) claims that support equipment such as the left ventricular assist device (LVAD) is required. Furthermore, passengers with the following health conditions are advised to have full-range observation 4-6 weeks before air travel (Koh, 2021). Hammadah et al.(2017) recommend using personal transport at the airport to diminish pre-travel exertion. Consuming in-flight food, including alcohol and caffeine, is also not recommended because of the high concentration of sodium in content. Following these suggestions help to reduce risks during air travel.

References

Hammadah, M., Kindya, B. R., AllardRatick, M. P., Jazbeh, S., Eapen, D., Wilson Tang, W. H., & Sperling, L. (2017). Navigating air travel and cardiovascular concerns: Is the sky the limit? Clinical Cardiology, 40(9), 660666.

Koh, C. H. (2021). Commercial Air Travel for Passengers With Cardiovascular Disease: Recommendations for Common Conditions. Current Problems in Cardiology, 46(3), 100768.

Some of the deadliest diseases in human history include acquired immunodeficiency syndrome (AIDS), cholera, influenza, smallpox, bubonic plague, and COVID-19. According to MPH Online (2021), the influenza pandemic of 1918 had the highest death rate of up to 50 million people. Another pandemic was HIV/AIDs identified first in 1976, but it reached its peak between 2005 and 2012 (MPH Online, 2021). Since 1981 HIV/AIDs has killed over 36 million people, becoming a global issue (MPH Online, 2021). In addition to HIV/AIDS, the third (the 1850s) and sixth cholera (1910) epidemics killed many people (MPH Online, 2021). Cholera has had a repetitive reoccurring nature, and it originated in India. Finally, the world experienced the most recent pandemic in 2019, COVID-19. The COVID-19 death toll today is at 6.26 M, with 519M cases (MPH Online, 2021). Although similarly devastating, these pandemics are different in how they can be transmitted and eradicated.

One of the leading causes of pandemics is a viral infection. COVID-19 and influenza, for instance, are viruses that attack the respiratory system. The coronavirus that causes COVID-19 spreads through the air when people receive contaminated droplets as they breathe in or touch infected fluids. AIDS is caused by a human immunodeficiency virus (HIV)  it spreads through sexual intercourse and infected blood. Cholera is a bacterial infection spread through ingested contaminated foods and liquids. It is challenging to eradicate quickly spreading diseases  thus, prevention becomes the primary tool in addressing their impact. In the cases of COVID-19 influenza, masks, hand hygiene, and vaccination are used. AIDS is managed similarly by educating people about safe sex and needle use. Moreover, antiretroviral therapy is used for treating HIV, but no cure for AIDS has been developed. For such infections as cholera, sanitation is seen as the major source of improvement.

Overall, deadly diseases continue to affect whole communities to this day. Such diseases as AIDS still do not have an effective cure, and some countries have many cases. Other conditions such as cholera are managed with nonpharmaceutical measures. The most recent infection that caused a pandemic is COVID-19, and it is combated with preventive measures and vaccination. Deadly diseases are better managed with the help of modern medicine, but science still has many problems it needs to solve.

Reference

MPH Online. (2021). Outbreak: 10 of the worst pandemics in history. 

Introduction

Addisons disease is a condition which develops in the human body most frequently as a result of autoimmune adrenalitis and damages adrenal tissue, which ultimately hinders the production of cortisol (Rumsby and Woodward 168). The adrenal cortex, which is unable to produce enough glucocorticoids and mineralocorticoids, may potentially cause an adrenal crisis (Barthel et al. 165). Medical professionals have to able to detect this disease in patients as soon as possible since it can be extremely life-threatening and lead to death.

Physiology and Anatomy

The adrenal glands are a part of the endocrine system that can be found above each kidney and have a triangular shape (Johns Hopkins Medicine). These glands are divided into two parts the inner one, the medulla, and the outer one, the adrenal cortex. The main function of the latter is to produce steroid hormones, while the purpose of the former is to secret hormones which are responsible for controlling stress response (Johns Hopkins Medicine). The adrenal cortex comprises three important areas that produce different hormones and are vital for the proper functioning of peoples bodies and organs (Johns Hopkins Medicine). Zona glomerulosa produces a mineralocorticoid hormone called aldosterone, which regulates blood pressure and blood pH by adjusting the electrolytes level (Johns Hopkins Medicine). Zona fasciculata secrets cortisol, which is a glucocorticoid hormone that reduces inflammation in the body and monitors the use of proteins, carbohydrates, and fats (Johns Hopkins Medicine). Finally, Zona Reticularis produces weak male hormones, androgenic steroids, and dehydroepiandrosterone (DHEA), which are later converted into estrogens or androgens (Johns Hopkins Medicine). Thus, a lack of hormone production in adrenal glands increases the risk of Addisons Disease, which can lead to death if not treated.

Symptoms and Effects

Knowing the symptoms of the disease is crucial when diagnosing it since this condition is relatively rare. Patients with Addisons Disease often experience overall weakness, fatigue, and considerable weight loss, as well as problems with the gastrointestinal tract (Barthel et al. 165). These symptoms develop over several years and can be unnoticeable for patients who may link them to other conditions. Frequently, patients become diagnosed with Addisons Disease after experiencing substantial stress, which highlights deficiencies in cortisol and aldosterone in their body. Low levels of these hormones can ultimately cause orthostasis, hypotension, and even adrenal crisis, which is an acute condition with potentially lethal complications (Dineen et al. 3). Another symptom of Addisons Disease is hyperpigmentation, which is caused by an adrenocorticotrophic hormone (ACTH), which stimulates the melanocortin 1 receptor and leads to a darkened skin tone. Hyperpigmentation is not limited to one particular area and can spread across the entire body, including on buccal mucosa and lips vermilion border (Michels and Michels 564). Although it must be noted that these symptoms are not always caused by Addisons Disease and can be results of other conditions, thus, professionals have to conduct necessary tests before diagnosing.

Causes and Risk Factors

Several decades ago, tuberculosis, which initiated bilateral adrenal destruction, was the main cause of Addisons Disease in the world, yet, nowadays, it affects most people in developing countries (Fofi et al. 23). In the majority of patients in developed nations, the onset of primary adrenal insufficiency is caused by other autoimmune diseases, for example, autoimmune adrenalitis (Fofi et al. 23). Autoimmune adrenalitis, which destroys the adrenal cortex, can be both an isolated disorder and occurring together with other types of autoimmune diseases in autoimmune polyendocrinopathy syndrome (APS), a rare autosomal recessive syndrome. Infectious diseases, especially chronic ones such as bilateral adrenal tumors, including lung cancer, melanoma, sarcoidosis, histoplasmosis may provoke Addisons Disease. The adrenal cortex in patients bodies can also be destroyed as a result of hemorrhage caused by meningococcemia. Moreover, chronic conditions such as AIDS often suppress the secretion of cortisol and aldosterone in the human body, which may trigger Addisons Disease or worsen other symptoms (Lang 42). Researchers still find new conditions influencing Addisons Disease, which makes it difficult to trace the primary adrenal deficiency to one particular cause.

Statistics

As it was mentioned earlier, Addisons disease is a relatively rare disorder that has a prevalence of 411 per 100 000 and an incidence of 0.8 per 100 000 population/year (OConnell and Siafarikas 834). The condition is thirty times less prevalent than type 1 diabetes and two-hundred times less frequent than autoimmune thyroid diseases. During childhood, boys are more likely to develop this condition since they account for 75% of all patients, while among adults, women constitute the majority of cases, which is 70%. Females are also more susceptible to Addisons disease if it occurs in combination with polyglandular autoimmune syndromes. When the condition is isolated, it more frequently affects males under twenty years old (Fofi et al. 24). The syndrome is widespread among specific ethnic groups such as Sardinian (1:14,000), Finnish (1:25,000) and Norwegian populations (1:90,000) (Mitchell and Pearce 308). Nevertheless, it is worth mentioning that Addisons disease can be found across different segments of society, and people of any age, gender, and race. The statistics of western countries demonstrate a much better picture than those of developing countries, where the problem is exacerbated by the healthcare issues.

Treatment

Treatment for Addison disease implies a hormone therapy using glucocorticoids and mineralocorticoids, only if the level of aldosterone is also quite low, the standard treatment regimen involves taking hydrocortisone or prednisone (Michels and Michels 564). For example, the latest study has shown that glucocorticoid therapy helps decrease GDF15 hormone responsible for reducing food intake in patients with Addisons disease (Melvin et al. 1432). According to the recommended guidelines of the Endocrine Society, cortisone acetate or hydrocortisone can be given to patients three times a day in equal doses (Rumsby and Woodward 175). Although, there is an alternative to these drugs, particularly in the form of prednisolone, which can be offered to patients who require a simpler therapy in order to improve comfort (Barthel et al. 167). Moreover, as demonstrated in one study, dual-release hydrocortisone preparation showed better results than conventional hydrocortisone therapy. The research indicated that this type of treatment contributed to more effective lipids metabolism and significantly reduced central adiposity, which impaired the glucose level (Giordano et al. 367). Thus, hydrocortisone therapy must be the primary means of treating Addisons disease in the majority of cases.

Conclusion

Addisons disease or primary adrenal deficiency is a serious condition that affects people of all ages, genders, and races and constitutes adrenal glands insufficient production of hormones such as cortisol and aldosterone. This condition occurs when the outer layer of the adrenal glands, the adrenal cortex, suffers damage and stops to secret the aforementioned hormones, which are vital for the human body. The main symptoms of this disorder are weakness, fatigue, weight loss, and hyperpigmentation, which causes the skin tone to become darkened. Nowadays, the development of Addisons disease is largely attributed to other autoimmune conditions such as autoimmune adrenalitis and infectious diseases, for example, adrenal tumors. The disorder is quite uncommon, and it is most prevalent among adult females and males during their first twenty years of life. The primary treatment for Addisons Disease is hormone therapy based on glucocorticoids, namely, hydrocortisone, which has been proved to be the most effective solution.

Works Cited

Barthel, Andreas, et al. An Update on Addisons Disease. Experimental and Clinical Endocrinology & Diabetes, vol. 127, 2019, pp. 165175.

Dineen, Rosemary, et al. Adrenal Crisis: Prevention and Management in Adult Patients. Therapeutic Advances in Endocrinology and Metabolism, vol. 10, 2019, pp. 112.

Fofi, Claudia, et al. Renal Involvement in Adrenal Insufficiency (Addison Disease): Can we Always Recognize it? Internal and Emergency Medicine, vol. 15, 2019, pp. 2331.

Giordano, Roberta et al. Improvement of Anthropometric and Metabolic Parameters, and Quality of Life Following Treatment with Dual-Release Hydrocortisone in Patients with Addisons Disease. Endocrine, vol 51, no. 2, 2015, pp. 360368.

Johns Hopkins Medicine. Adrenal Glands. Johns Hopkins Medicine, 2020. 

Lang, Florian, editor. Encyclopedia of Molecular Mechanisms of Disease. Springer, 2009.

Melvin, Audrey, et al. GDF15 Is Elevated in Conditions of Glucocorticoid Deficiency and Is Modulated by Glucocorticoid Replacement. The Journal of Clinical Endocrinology & Metabolism, vol. 105, no. 5, 2020, pp. 14271434.

Michels, Aaron, and Nicole Michels. Addison Disease: Early Detection and Treatment Principles. American Family Physician, vol. 89, no. 7, 2014, pp. 563568. 

Mitchell, Anna L., and Simon H.S. Pearce. Autoimmune Addison Disease: Pathophysiology and Genetic Complexity. Nature Reviews Endocrinology, vol. 8, no. 5, pp. 306316.

OConnell, Susan, and Aris Siafarikas. Addison Disease: Diagnosis and Initial Management. Australian Family Physician, vol. 39, no. 11, 2010, pp. 834837.

Rumsby, Gill., and Gary M. Woodward, editors. Disorders of Steroidogenesis. Springer, 2019.